DR. ERIC SANTO VALLONE M.D. NPI 1598825655
Internal Medicine in Fairfax, VA
About DR. ERIC SANTO VALLONE M.D.
Eric Vallone is an internist established in Fairfax, Virginia and his medical specialization is Internal Medicine with more than 26 years of experience. He graduated from Georgetown University School Of Medicine in 1997. The NPI number of this provider is 1598825655 and was assigned on December 2006. The practitioner's primary taxonomy code is 207R00000X with license number 0101059057 (VA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
| NPI | 1598825655 |
| Provider Name | DR. ERIC SANTO VALLONE M.D. |
| Location Address | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 |
| Location Phone | (703) 352-7100 |
| Mailing Address | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1997 |
| Is Sole Proprietor? | No |
| Enumeration Date | 12-11-2006 |
| Last Update Date | 12-27-2007 |
An internist like Eric Vallone is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Eric Vallone is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Eric Vallone is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with .
The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: chronic care and preventative care management for empaneled patients, e-prescribing, health information exchange, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, patient-specific education, provide patient access, secure messaging and security risk analysis. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
The typical physician office visit costs for Medicare beneficiaries in this area are: $38.79 for a new patient copayment and $30.05 for an established patient copayment.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207R00000X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 0101059057 |
| License State | VA |
| Taxonomy Description | A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
3911 OLD LEE HWY
#41C
FAIRFAX, VA
ZIP 22030
Phone: (703) 352-7100
Fax: (703) 591-7106
Mailing Address
3911 OLD LEE HWY
#41C
FAIRFAX, VA
ZIP 22030
Phone: (703) 352-7100
Fax: (703) 591-7106
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9830287812 |
| PECOS Enrollment ID | I20071109000191 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 22030 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $68.56 | $204.56 | $155.19 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $17.14 | $51.14 | $38.79 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $21.87 | $167.24 | $120.2 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $5.46 | $41.81 | $30.05 |
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| e-Prescribing | 92% | 4050 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 87% | 596 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 252 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 92% | 1135 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 98% | 1087 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 82% | 1087 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 161Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
- 147Pneumococcal vaccine for injection into muscle (HCPCS:90670)
- 145Administration of pneumococcal vaccine (HCPCS:G0009)
- 121Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
- 107Administration of influenza virus vaccine (HCPCS:G0008)
- 58Urinalysis, manual test (HCPCS:81002)
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| H54311 | MEDICARE UPIN (02) | VA |
| 00A750D42 | MEDICARE PIN (08) | VA |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 9 | 8 | 8 | 2 | 5 | 6 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 18 | 8 | 16 | 2 | 10 | 6 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 8 + 8 + 1 + 6 + 2 + 1 + 0 + 6 + 1 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1598825655 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1609968874 | DR. LIDA MARIA VARGAS D.D.S Individual | Dentist | 3911 OLD LEE HWY SUITE 42 C FAIRFAX, VA 22030 (703) 385-3800 |
| 1366502429 | DR. DANIELE NUNEZ M.D. Individual | Family Medicine | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 (703) 352-7100 |
| 1164766572 | 1ST CLASS SLEEP DIAGNOSTICS, INC Organization | Clinical Medical Laboratory | 3911 OLD LEE HWY SUITE 42-B FAIRFAX, VA 22030 (703) 385-9222 |
| 1639542160 | LOUDOUN MEDICAL GROUP PC Organization | Family Medicine | 3911 OLD LEE HWY SUITE 41-C FAIRFAX, VA 22030 (703) 317-9500 |
| 1194885277 | DR. KATHLEEN CRANE-LEE M.D. Individual | Family Medicine | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 (703) 352-7100 |
| 1013077148 | DR. DAVID DRAKE LEONARD M.D. Individual | Family Medicine | 3911 OLD LEE HWY SUITE #41C FAIRFAX, VA 22030 (703) 352-7100 |
| 1366570400 | FAMILY PHYSICIANS OF OLD TOWN FAIRFAX PC. Organization | Family Medicine | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 (703) 352-7100 |
| 1457662660 | DR. MARGARET DOLAN ROCKWOOD M.D. Individual | Family Medicine | 3911 OLD LEE HWY #41C FAIRFAX, VA 22030 (703) 352-7100 |
Frequently Asked Questions
What is Dr. Eric Vallone M.D. NPI number?
The NPI number assigned to this healthcare provider is 1598825655, registered as an "individual" on December 11, 2006
Where is Dr. Eric Vallone M.D. located?
The provider is located at 3911 Old Lee Hwy #41c Fairfax, Va 22030 and the phone number is (703) 352-7100
Which is Dr. Eric Vallone M.D. specialty?
The provider's speciality is Internal Medicine
How many years of experience does Dr. Eric Vallone M.D. have?
The provider has more than 26 years of experience. He graduated from Georgetown University School Of Medicine in 1997.
What insurance does Dr. Eric Vallone M.D. accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Dr. Eric Vallone M.D. registered in PECOS?
Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
How much is a visit to Dr. Eric Vallone M.D.?
Medicare beneficiaries should expect a typical cost of $155.19 with an average copayment of $38.79 for new patient appointments. Established patients should expect a typical charge of $120.2 and an average copayment of 30.05. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Dr. Eric Vallone M.D.?
The most common procedures or services performed by this practitioner are: Routine EKG using at least 12 leads including interpretation and report, Pneumococcal vaccine for injection into muscle, Administration of pneumococcal vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Administration of influenza virus vaccine and Urinalysis, manual test.
How do I update my NPI information?
The NPI record of Dr. Eric Vallone M.D. was last updated on December 11, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.